Cases

Man in his late seventies comes in with his wife,
weak, lost twenty-five pounds, can't eat, hard to talk,
seeing double off and on past eighteen months,
been to a family doctor and two specialists.

They don't know, I've got some ideas. It's
beyond my scope, here in the rural north country.
I get him tucked away in the medical center
by the following morning. He's out in five days

with a diagnosis, I was right for once. He's
eighty percent better on treatment, says
he's two hundred percent. Gives me the credit
for once. The gray hair helps. Man comes in

to emergency with loss of vision in one eye.
works full-time, in his sixties. It goes away
and he wants to go home. Internist and eye doctor
find nothing. I find something and say, No.

Family says I'm overreacting but they all agree,
reluctantly. Urgent angiogram-surgery on the
neck arteries is booked for the following morning.
That night his opposite side becomes paralyzed.

Emergency surgery cleans out a nearly
blocked vessel. They don't appreciate the
postoperative pain. They don't appreciate my
style or anything about me. He walks out

saved from an almost certain permanent
disability. Woman comes in with a headache,
high blood pressure, in her fifties. I do a spinal,
few red cells, radiologist gets me on the phone.

He says the CAT scan's negative, I'm not
so sure and send her down country for an
angiogram. Radiologist was right and I was
wrong  no aneurysm in her brain. Young

mother of two comes in with seizures hard to
control all her life, and paralyzed on the right side
from birth. I consider a CAT scan a waste of money:
the gray hair stands for experience, remember?

She gets slowly worse over the years. Her family
doctor does a CAT scan, finds a malformation
of the brain. We just ain't so smart, my old
teacher used to say when I was an intern. A man

comes in, in his sixties, can't work, losing weight,
muscles are twitching, hard to swallow, hard
to talk. Do some tests, tell his wife and him
he's got Lou Gehrig's Disease, it will affect

his breathing, he's going to die, it will be
tough, we'll try some things. We do, he gets
worse, can't walk, can't feed himself.
I visit the house: a small cape with a screened

Porch behind a variety store in a small town in
New Hampshire. He gets worse, I
visit some more, talk some to him,
to his wife and son, the man dies.

Literary and Historical Notes:

It's the birthday of Jacob Grimm, (books by this author) born in Hanau, Germany (1785). He and his younger brother Wilhelm, who was born a year later, collected and published Grimm's Fairy Tales in 1812, which led to the birth of the study of folklore.

It's the birthday of the man who invented a system of reading and writing for the blind, Louis Braille, born in Coupvray, France (1809). He was blinded in his father's harness shop when he was three years old. But even without his eyesight, he was the best student in his school, and went on to become a famous organist and cellist in Paris.

But when he was still a student, Louis Braille was frustrated by his inability to read and write. Then, he heard about a French army officer who had devised a system of written communication of raised dots and dashes for nighttime battles. Braille borrowed the idea of the dots, and set about creating an alphabet that could be read by touch. He decided that each letter would be represented by a different arrangement of six dots packed close enough that each letter could be read by a single fingertip.

Braille died in 1852, and his alphabet for the blind didn't come into widespread use until 1878, when it was presented at an International Congress in Paris. It went on to be used for virtually every major world language, and it was adapted for mathematical calculations and musical notations. Braille's system made it possible for the first time for the blind to learn to read and write and to enter practical professions.

But today, reading and writing of Braille is something of a dying art. There are now far more audio versions of books than there are books printed in Braille, and there are software programs to convert written text into audio. Today only about 10 percent of blind children in this country learn to read Braille.

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